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General NPI Number Information
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NPI Number | 1881110856
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Entity Type | Individual
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Provider Name | ELIZABETH A HARLAN LMT
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Gender | Female
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Dates
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Enumeration Date | 08/21/2017
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Last Update Date | 08/21/2017
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Provider Practice Location Address
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Address Line | 11901 BUSINESS BLVD STE 108
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City | EAGLE RIVER
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State | AK
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Zip | 99577-7701
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Country | US
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Telephone | 907-694-1285
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 772017
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City | EAGLE RIVER
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State | AK
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Zip | 99577-2017
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Country | US
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Telephone | 727-207-9472
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 108105
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License Number State | AK
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